Injection of bleomycin as a primary therapy of cystic lymphangioma.

Forty-five patients (19 boys and 26 girls) with lymphangioma have been treated at Osaka University Hospital during the 10-year period from January 1978 to December 1987. Twenty-nine underwent initial bleomycin (BLM) therapy. These patients' lesions consisted of large cystic masses that were demonstrated by echography or computed tomography scans. BLM was administered as a solution of 1 mg/mL in saline, after aspiration of the cyst contents using a puncture needle. The total dose ranged from 3 mg to 32 mg (average, 10 mg) and was administered between 1 and 16 times. Of the 29 cases treated with BLM, 25 cases (86%) showed significant reduction of the mass and 16 (55%) showed complete disappearance. Recurrence occurred in 3 patients. One responded to further injection of BLM, and the other 2 required surgical resection. Thirteen patients required surgical resection; however, in those cases, the previous injection of BLM was found to minimize the extent of surgical resection required. There were no serious side effects with BLM injection. Injection of BLM as an initial treatment of cystic lymphangioma was found to be very useful. It can reduce the size of the mass and even result in complete disappearance; consequently, it can minimize the frequency and extent of surgical intervention.